Jaques, Jonathan G
Jaques, Jonathan G is an individual health care provider with primary practice located at 75 Lindall St , Danvers MA 01923-2121. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Jaques, Jonathan G can be contacted via phone (978) 774-4400.Contact Information
Primary practice address
75 Lindall St
Danvers MA 01923-2121
Phone: (978) 774-4400
Fax: (978) 777-1462
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 75534 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 75534 | Massachusetts |
Profile Details
| NPI number | 1164412052 |
|---|---|
| LBN Legal business name | Jaques, Jonathan G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164412052 | NPPES |
| Massachusetts | MEDICAID | 3091023 |
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